人文关怀护理对乳腺癌围手术期病人自我护理能力的影响

Effects of humanistic care on the self-care ability to the perioperative patients with breast cancer

目的探讨人文关怀护理对乳腺癌围手术期的病人自我护理能力的影响。方法采用方便抽样的方法,选取住院乳腺癌围手术期210例病人作为研究对象,以抛硬币法将两个病房随机分为干预组和对照组,各选取105例。对照组病人只进行一般性的常规的护理,干预组病人则在常规的基础上给予系统的人文关怀护理。主要包括:病人术后由责任护士、心理治疗师、手术医生和病人一起制定阶段性康复计划,帮助术后病人消除不合理认知,完成认知重建;邀请心情低落的病人做沙盘游戏;科室适当举行医患联谊会,让已经康复病人用自己的切身经历现身说法。该研究用自我护理能力测定量表调查乳腺癌病人自我护理能力,并比较两组病人手术之后并发症的发生率。结果干预组在施加系统的人文关怀护理举措后,病人自我护理能力的总分、自我概念、自我护理技能、自我责任感、健康知识水平均高于对照组(P<0.01),术后出血、上肢肿胀以及皮下积液的发生率相比对照组有所降低,差异有统计学意义(P<0.05)。结论施加系统的人文关怀护理举措可以增强病人的自我护理能力,同时也能降低并发症的发生率。

Objective To explore the effects of humanistic care on the self-care ability to the perioperative patients with breast cancer. Methods 210 patients were selected through convenience sampling method from two mammary gland surgical wards of our hospital. One of the wards was randomly chosen as intervention group, while the other was considered as control group through tossing a coin. Each ward recruited 105 patients as a research object. The patients in the control group received usual care,and the intervention group received both usual care and humanistic care,which mainly included that the primary nurse,psychological therapist and surgeon would work with the patients to make a phased rehabilitation plan after surgery aimed at helping the perioperative patients correct the wrong cognition,inviting depressed patients to play sand table games, the experimental ward regularly held the sodality to invite the rehabilitation patients to share their own experiences. Using the exercise of Self-Care Agency Scale （ESCA） to assess their self-care a- bility,and the incidences of complications after surgery in two groups were compared. Finally,the overall incidence of complications was compared between the two groups. Results The scores of ESCA, self-concept, self-nursing skills, self-responsibility and health care knowledge in the observation group were superior than that in the control group（P 〈0.01）. Also,the incidence of bleeding,upper limb swelling,subcutaneous hydrops in the observation group was lower than that of the control group （P 〈0. 05） . Conclusion Implemen-ting humanistic care can improve the ability of self-care and reduce the occurrence of complications.